Individual ProviderShana DasturSocial WorkerBehavioral Health & Social Service ProvidersPractice Address406 10th Ave, 9th Floor, New York, NY 10001-2320(718) 488-0100(718) 208-3603PECOS EnrollmentBased on the most recent information from CMS, provider Shana Dastur does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:56 PM.Profile DetailsProvider ID1255534368Provider TypeIndividualFull NameDastur, ShanaTitleMrs.CredentialL.C.S.W.GenderFemaleSole ProprietorNoEnumeration Date6/6/2007Last Updated7/9/2012Contact InformationPractice LocationPractice Address406 10th Ave, 9th Floor, New York, NY 10001-2320Phone(718) 488-0100Fax(212) 273-6507Mailing LocationMailing Address139 Forest Ave, West Caldwell, NJ 07006-7962Phone(718) 208-3603FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense078540New YorkCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense076100New York